Active NPI
Theresa Johnson, DNP, MS,FNP-BC
- Nurse Practitioner
- Dearborn, MI
National Provider Identifier
1366849069
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 4704285116
- Practice address
- 3200 Greenfield Rd Ste 300
Dearborn, MI 48120-1805 - Phone
- (313) 334-6395
- NPI assigned
- Nov 24, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 4704285116 | MI | |
| Nurse Practitioner | 363L00000X | 4704285116 | MI | Primary |
Addresses
Primary practice location
3200 Greenfield Rd Ste 300
Dearborn, MI 48120-1805
Mailing address
17778 Violet Dr
Southfield, MI 48076-2098
Phone (483) 182-2092
Other practice location 1
28050 Grand River Ave
Farmington Hills, MI 48336-5919
Phone (313) 618-9028
Other practice location 2
310 Visger Rd
River Rouge, MI 48218-1037
Phone (313) 982-7839
Other names 1
- Theresa Johnson
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2014
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
28050 Grand River Ave
Farmington Hills, MI 48336-5919
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704285116 | MI | MD | Family Nurse Practitioner |
Interoperability endpoints
- theresa.johnson@beaumont.org
- tjohnson734242@direct.hfhs.org
- tjohnson1240159@epic00.shdirect.org
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Hospitalist Physician
- Royal Oak, MI
- NPI 1427567858
Hospital & facility affiliations 8
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Beaumont Hospital-Farmington Hills
- General Acute Care Hospital
- Farmington Hills, MI
- NPI 1336183367
-
dba Internal Medicine Associates Farmington Hills
- Internal Medicine Physician
- Farmington Hills, MI
- NPI 1538103395
Hospital
-
dba Botsford Thoracic Surgery Clinic
- Internal Medicine Physician
- Farmington Hills, MI
- NPI 1912335373
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1416787200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1787529600000",
"number": "1366849069",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17778 VIOLET DR",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480762098",
"telephone_number": "483-182-2092"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3200 GREENFIELD RD STE 300",
"city": "DEARBORN",
"state": "MI",
"postal_code": "481201805",
"telephone_number": "313-334-6395"
}
],
"practiceLocations": [
{
"address_1": "28050 Grand River Ave",
"address_purpose": "LOCATION",
"city": "Farmington Hills",
"state": "MI",
"postal_code": "483365919",
"country_code": "US",
"telephone_number": "313-618-9028",
"fax_number": "482-471-8896",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "310 Visger Rd",
"address_purpose": "LOCATION",
"city": "River Rouge",
"state": "MI",
"postal_code": "482181037",
"country_code": "US",
"telephone_number": "313-982-7839",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JOHNSON",
"first_name": "THERESA",
"credential": "DNP, MS,FNP-BC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-11-24",
"last_updated": "2026-08-24",
"certification_date": "2026-08-24",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MI",
"license": "4704285116",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MI",
"license": "4704285116",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "THERESA",
"last_name": "JOHNSON",
"credential": "THERESA JOHNSON, NP",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Dearborn, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.